I listened to Governor Bentley’s State of the State address last night, and then read (and re-read it) online. Lots of broad statements, some tantalizing. I can’t comment yet on implications for Medicaid, until we see how the specifics are laid out in the actual budget. I’ll let you know as soon as I can. It sounded like he has figured out a way to use Education money for Medicaid. I have some guesses but no better than trying to figure out the end of an episode of “The Mentalist.”
I thought you might want to look at a few pieces of legislation related to healthcare. There are several pre-filed bills, some of which I’m still researching. These include return to play for high school concussions, privacy for genetic diseases, treatment and diagnosis of bleeding disorders, definitions of controlled substances, personhood, drug screening for people who receive state healthcare benefits, healthcare provider conscience, and the multistate Healthcare Compact. I’m sure there will be others! Please let me know if there is a specific bill you want me to address.
Here’s one that looks fairly innocuous, on the face of it—HB 78, Genetic Information Privacy Act. I’m picking it first because even though I don’t have any fiery emotions on the subject, the implications are interesting and fun to think about. I promise to get the more serious stuff later. Think of this as a beach read day or a warm-up.
I suppose the intention is to keep employers from discriminating against people who are at higher risk of disability. But I think the necessary privacy is already covered under existing healthcare law. Anybody know why this one got written? There’s always a back-story.
Patients (or representatives) would have to sign specific, separate consent for genetic testing that includes the risks and benefits. Fortunately, the state newborn screens that test for important conditions like cystic fibrosis are excluded. Release of the information would also have to be specifically signed for.
First, look at how “Genetic Information” and testing are defined. The bill acknowledges that it isn’t just DNA but the proteins coded for by the DNA—so things like blood type would be included. Remember those cool little taster strips from science class, the ones some of your friends found nasty and others not? The ability to sense that bitter taste is a genetic property, and one’s taster status would be genetic information.
The bill tries to prevent such over-application by saying it only applies to genetic information related to increased risk of a disease or disorder. They probably don’t realize how much research has been done related to increased disease risk for various genetic markers like blood type, eye color, hair color, taster status, etc. And new information comes out constantly. Since this law doesn’t just apply to physicians but to all of us, with penalties for releasing genetic information about another person without written consent, imagine the implications!
Even one’s gender is genetic (or starts that way prior to surgery)—we are XX, XY or some variation. And our sex chromosomes do definitely predispose us to various illnesses. I know that sounds silly and that the legislature doesn’t intend to punish us for publicly saying we know a certain person is male or female—but in between that and saying a person has something like Trisomy 21 (Down Syndrome), there is a lot of gray area. Way more gray area than they realize.
Even for the specific conditions like Trisomy 21, this bill creates new and unnecessary paperwork. We have to fill out tons of forms for camp, therapy authorizations, etc, where a child’s specific problem is supposed to be identified, at the parent’s request. Will we now have to complete a separate consent form for each of these?
The regulations about storage of samples doesn’t make sense either. It only applies to specimens that were collected specifically for genetic testing—but don’t they realize that all our cells have DNA? Why should a sample be protected differently just based on initial intention, when the same information is available from all sorts of other biologic samples? Including your hairbrush? It wouldn’t substantially protect us from misuse of our genetic information. And it could add more cost to patients for changes in storage practices.
We already have very strict medical privacy laws to protect our healthcare information. We have laws against discriminating against people on the basis of disability. This bill is probably very well-intentioned but I think all it would do is make paperwork and confusion. Let’s don’t!
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Sign in now[...] We don’t have to leave our homes and journey to Africa in order to follow Christ. There are multitudes of opportunities to serve the needs of others right here in Huntsville. We can also join the fight against injustice and greed. Let me suggest you check out Pippa Abston’s blog post this week: http://pippaabston.wordpress.com/2012/01/16/we-have-a-situation-alabamas-children-menaced-by-out-of-... [...]
Idea, why don’t we legalize marijuana, tax it and ear mark proceeds for healthcare? While we are at it, increase “sin taxes” on cigarettes, beer, wine, liquor, soft drinks, high sugar soft drinks, maybe even gasoline…. These items contribute to our health problems: so, why not let them help pay for the illness that they cause…
I understand these concerns and appreciate the “reality check” here regarding the vagaries of a .gov controlled decision making apparatus. However, my instinct tells me an allowance for private options will not, in the end, be a win-win. I do not feel certain that more money coming into the system via private plan payments will lead to more Public resources being freed up for health care here in the USA.
I also would need to explain to those with whom I speak who “we” are in this context, when I have these discussions locally…. Who is the “we” who will be allowed to purchase supplemental insurance from private corporations? At the moment I do not have it in me to raise this option of a parallel track to the 20-30 year old folks I often speak to about reform. They are not part of the “we” who can afford to maneuver around wait lists or denials by purchasing a ticket to the front of the line.
I suspect this was made illegal in Alberta because in a voracious and
cold hearted capitalist system for health care provision, it would be inevitable that those with money would overpower those without.
[...] the Word Out: Medicaid and a New Rash Remember our Medicaid “situation”? Out-of-state for-profit corporations trying to take over Alabama’s Medicaid, at risk of [...]
Perhaps you should let the people of Alabama know what has happened in Hawaii with Medicaid managed care. It is tempting to be able to set a fixed budget for Medicaid, but the Medicaid managed care plans have high administrative overhead, lack the will or means to actually improve care coordination, have incentives to deny care and avoid paying the bills, and lack any accountability to the public for the destructive effects of their policies. See the first section in the Hawaii Health Authority’s report to the Governor and Legislature on the history of Medicaid managed care in Hawaii.
http://hawaii.gov/budget/hha
Follow the link to “2011 Update”
Pippa, thank you for very good information. I will be getting letters, e-mails or whatever out to as many as I can. I plan to call the Admn of Medicaid Agency and see what I find out (no telling who I will talk to?) but I will try.
thanks,
ng
[...] Abston's Blog Skip to content Home ← Getting the Word Out: Medicaid and a New Rash February 1, 2012 · 4:04 pm ↓ Jump to [...]
hospitals, nursing homes and similar centers will negotiate a global annual budget, based on their past expenses and projected changes.
I did a lot of complex budgeting and forecasting when I was in the private sector and if faced with the 676 task I would find it daunting. Implementation of 676 will create significant changes to the business-as-usual-scenario and in many aspects of budgeting these changes will negate any ability to rely on past expenses as a benchmark. The second challenge of budgeting/forecasting based on “projected changes” is enormously challenging. Perhaps the details around budget creation have been addressed at the micro level by finance scholars in the Single Payer diaspora…?? One would need to create a simulated SP financing model and then start rearranging a hospital’s entire financial framework to begin projecting for future changes. VT (if it survives the onslaught of propagandists) will serve as one type of model, however if even one 400-500 bed hospital could attempt (i.e., simulate) a conversion of their budget structure it would be a worthy exercise. At the moment I cannot imagine hosp execs willing to play in this sandbox. It’s complicated because the budget negotiations for a hospital need to be based on solid data for SP to succeed. Early success is very important to allay concerns about SP as an excellent option for our future.
I realize most of those on this blog may be focusing on the language in 676 which outlines the ways in which MDs will be paid. But it’s all linked.
Respectfully submitted,
I’m slogging through the various amicus briefs at the moment. Actually pretty interesting stuff (the AHIP/BCBSA brief is pretty scary nominally, but it may just be an empty threat).
There are 4 principal issues before SCOTUS here:
1. Commerce Clause power challenge (re: Individual Insurance Mandate)
2. Severability
3. Medicaid Expansion challenge
4. Anti-Injunction Act “Ripeness”
Some beltway SCOTUS watchers are predicting 6-3 to uphold. We’ll know by June, I guess.
BTW, I’m with you on single payer. Not a big PPACA fan.
Also btw, I’m gonna add you to my REC blogroll.
I have not done research into how other countries, such as Canada, accomplish the long-term care aspect of cradle to grave health care. However, I will never forget a Canadian’s reply to my wife and me about long-term care. After living in Canada for 4.5 years and having many of my Canadian co-workers now living and working in my city in Michigan, my wife and I happened to speak with a Canadian a few years ago here in Michigan. Joan, the Canadian, happened to mention that she and her husband are definitely returning to Canada. She also mentioned that her father is getting fine long-term care in Canada. Yes, it’s input from just one person in one family. but my guess is that it can be confirmed that long-term care is generally fine in Canada, especially considering the horrific experiences that some families have experienced in the States.
About your question “what do you think” about how we’ll do it. I could care less about losing some personal control. I one to be part of a one-tier system, not 1st class and 2nd class. Those with money who want to get superior care in a semi-luxurious or “better” setting will always have that option. I am guessing that some people will go around the system for long-term care. I just want to be part of the “masses” who will show their card and get care, like that Joan’s father, above, who is doing just fine in his nursing home.
As I wrote the first part, above, I was reminded of the following:
—- Canadians love their health care, as indicated by the data …
http://mforall.org/p/944
—- Canadians love their health care, as indicated by the video (and the transcript excerpts)… of 11 Canadians ages 40 to 90
http://mforall.org/p/995
—- Canadian-Americans who love their Canadian health care, as indicate by their experiences, including the two families who describe themselves an exiles from the United States
http://mforall.org/p/742#cantcomehome
- Bob the Health and Health Care Advocate.
I agree– as far as choices go, I wasn’t talking about luxury. I just meant that sometimes, especially in cases of mental illness disability, it takes time to find the right caregivers. You don’t necessarily want a “sitter” so much as someone who will treat your loved one like a human being. We have had some unfortunate experiences. Some people who go into that field are competent but not caring or respectful. Others are downright dangerous. One attendant left our family member in a van full of other disabled people with the engine/ AC off and the windows closed in the middle of the hot summer while he waited in line at the bank for half an hour. But I imagine that if agencies were getting fairly paid for their services, families would be able to insist on access to compassionate caregivers.
Good follow-up, especially about people getting fairly paid, which is often lacking in the United States, as I have observed and read. To the extent that anyone knows about the subject in other countries I look forward to reading here any further hints and / or facts about long-term care in other free-market countries.
Wow. This blog is a perfect example enormous of medical-social complexity. First off, I completely agree with the author’s sentiments. Second, I have realized after countless calls and letters to my 2 senators how futile it is to engage them on issues like this. I have mostly received responses of rather extreme anger when I raise any of these topics (in the context of healthcare, equity, justice). In NH, the legislature cut $200 million annually from fed/state funds which hospitals receive (it is claimed that this hits hospitals in the financial category of uncompensated care). The justification from legislators is murky and illogical–the default is to blame Obamacare.
The following events immediately took place: all of the high-volume hospitals in the state started laying off personnel; all of the same institutions eliminated (or the equivalent) their access to those with acute mental health problems; some have made the newspapers by literally closing their doors to anyone on Medicaid. One fallout (which is now becoming commonplace in the USA) is that cops on-the-beat have become the front-line “providers” for those with mental health exacerbation and jail is now the “care” these patients receive. Another is the vast empty statistical “hole” that others affected by these decisions disappear into. If the doors are closed, then where does a pregnant woman go to have her child (not to mention prenatal care). Following that, with no means of payment as a result of no medicaid funding, both mother and child have no access for basic postpartum care, pedi care, immunizations, well-baby checks, assessment of problems, treatment of routine pedi-infections…. This whole picture displays a scary new definition of “Diversion.”
The state motto in NH is “live free or die.” Not being a native of this state, the motto has always embarrassed me. Now it has progressed to outright shame.
Thanks — I will take up the age issue also, good point! But I do want to caution that my philosophy does not include any mandate to CREATE or force connections. I am only addressing the reality that there are already connections that we deny at our peril.
When I get to the prejudice angle, I think I have a way to explain pseudo- speciation with my basic premise. That will be a whole separate post.
And… I should add that a person who actually understood the concepts behind Rational Connectionism would not likely falsify/ dramatize or otherwise twist a particular connection effect, at least not intentionally, to make it seem more powerful than it is. For instance, he would not say that if we pass a bill changing the retirement age the planet will explode. Not because the person is moral, but because he would understand that the unfortunate consequences of such manipulation would adversely affect him in some way which might be unpredictable. The trick would be, as always, for the rest of us to detect whether a person was pretending to understand Rational Connectionism in order to use it manipulatively, but did not really understand it. I can certainly imagine sociopaths who could fool most of us– but the more who DO understand how it works, the better analysis we could accomplish.
Reblogged this on Acoustic Poetree and commented:
A pediatrician’s perspective on the anti-choice bill in Alabama
I have removed the paragraph saying the bill allows the woman to be sued– the wording in this section was confusing, and after studying it some more, I do not think that’s what it says. The physician can be sued. Sorry for the error! I also had been told by others it allowed the woman to sue, but I just don’t see it in there.
You may recall that I have a now 10 year-old LO who, 5 years ago, had a teacher that was almost sure my LO was Autistic. I sobbed through that parent-teacher conference. How could my son have a mental disorder and I not notice it? What did I do? I beat myself up over having untreated post-Partum depression after he was born. I beat myself up for letting him watch an embarrassing amount of tv. It turned out that although he exhibited some of the behaviors of someone with Asperger’s Syndrome, he didn’t quite fit. He still has some behaviors that are not “normal” and I am constantly on the look out for new “odd” behaviors. Of course I have never experienced days anywhere as bad as your five. But, mental illness, especially Bi-Polar disease, runs in my family. Bi-Polar ruined my childhood and now I have anxiety and depression. Mental illness treatment must be funded to save kids and parents and all LO misery and even death.
Reblogged this on My Year To Thrive and commented:
I am still crying after reading this. I wanted to share it because it is such an honest & heartfelt look at what it is like to have a loved one with mental illness.
I have seen this too. Even before recent, and ever more draconian budget cuts, patients with schizophrenia were given minimal time and minimal protection. The real care fell to parents…who spent everything they had, and more. Most work environments are, these days, entirely inflexible for parents who need to help a loved one. Eventually, disruptions or absences from work means the parent loses their job. Bankruptcy, home foreclosure, which exacerbates their young son or daughter’s mental illness — with no safety net, our society has decided that police and jail are the “caregivers.”
Our entire health care system seems to think nothing of letting people die rather than treat their illnesses. The more I probe health care providers, the more I see their startling ignorance of what will befall innocent young people who have the misfortune of a chronic and life threatening disease.
My son, too, has a major health problem. Every word in the author’s story resonates. My “close friends” and family do not want to hear about it…the loneliness is unbearable sometimes. But it is far far worse for my son. These are the words I wrote recently in a casual email exchange to a friend who claims to “love me.” The reply from “my friend” did not acknowledge my words:
From my email to a friend: “I cannot find the words to express the howling winds of grief I live with as a mother who must watch her child suffer….”
I have an LO who is 27. Until 2 1/2 years ago there were no recognizable signs of mental illness. LO had graduated with distinction from college and had embarked on what was to be a wonderful life. Like many others LO lost his job with the downfall of the economy. Within a few months LO suffered his first “psychotic break”‘
LO called the ambulance and was taken to a hospital ER.
The ER Dr. called telling me he was there and they would inform me of where he would be taken. They never called, after 2 days of endless calls, tears and sleepless hours I received a call from a nurse who informed me she could not tell me if LO was there or not but if he was he was sleeping. I finally had a location a small crisis house in Chicago.
Two days later they released LO, he sold everything he owned and flew to New York.
I had no contact with LO for 11 months. Then the text messages started
and I panicked. I called New York police and they tracked him by his cell phone. LO was taken to a hospital where he was released shortly after admission. The messages started again, scary messages I called the police again.
The police went to the apartment and left when LO told him he was fine. Messages and rambling calls began again, I begged LO to go to the hospital. I received a call from a Mental Hospital LO was there! LO was very sick come right away. I flew out the next day and was at
the hospital within 6 hours. LO was sick, very sick it is impossible to describe the pain and sadness in seeing your child in this condition. Lo stay 5 weeks at this hospital and was diagnosed with Schizoaffective Disorder.
LO did not want to come home after discharge so we arranged lodging until further options would be available. LO is homeless and afraid of going to a homeless shelter the only money available to him is what we send. Two days later LO calls saying he is going to kill himself, the signs and voices are telling him it is time.
I call a different hospital as the previous one made sure they discharged LO out of their area so he could not return there. I called the police and informed them of his threat and they picked LO up and he was admitted to yet another hospital. LO stayed at this hospital 3 weeks, on the advice of Drs. and social workers we were told LO would have a much better chance of recovery with family support. My husband and I drove to New York collected LO and his belongings and began the long drive back. We immediately took him to the Mental Health Center and set up appointments with a Dr. and therapist.
The resources are very limited in Alabama. The Mental Health Center has 8,000 patients and LO can only see the Dr. once every 3 months and once or twice a month with the therapist.
Another nightmare begins. No insurance, No money, limited care.
LO gets a job and he is not ready for the stress, his mind
doesn’t work like it used to, he stops taking his medications to improve
his ability to think. Delusions return, voices return, his desire to hurt himself returns. I visit him frequently (he lives in an apartment that we provide). I spend the nights with him when he is afraid, he won’t eat, he
won’t drink, he thinks the food and drink are tainted. LO can’t sleep he cries, he paces, he has lost 10 pounds, his thoughts race I convince him to go to the hospital. We start the journey to a local hospital and one block before we reach the hospital he opens the door and tries to get out.
LO begs me to take him back to the apartment, promises he will take his medication. I take him back, frighten he will jump out of the moving car.
LO takes the medication then attempts to force himself to vomit for 20 minutes,he is convinced I have tricked him. The medicine finally takes affect and he sleeps for 24 hours. This process repeats itself several days later and I am finally able to get him to the hospital . Four hours later they release him with discharge instructions to return to Mental Health Center. The Mental Health Center must see him within 24 hours “it’s the law”. We call the Mental Health Center they can not see him they have 8,000 patients, there is no such law.
The next day I go to the apartment and LO is gone. Where is he? I
text, call no answer finally after several hours a return text “Boston”. What? LO is desperate he wants help, he wants to get better and the options here are limited. LO’s communication is one or two word text messages. I receive a call from an ER in Boston and LO is there and yes he is psychotic, yes he is planning suicide. LO was then transfered to a Mental Hospital where he stayed 17 days.
LO is back here again taking his medications and continuing go to appointments at the Mental Health Center. Now we learn the limited services we have are facing a 25 percent cut. Making cuts to a service that is stretched passed capacity is endangering all of our LOs. I realize the stigma is great regarding the mentally ill. We must remove the stigma. Mentally Ill do not chose this anymore than someone chooses cancer.
It is a disease. I will not give up hope!
Society must not turn there backs on these people. Prisons and Homeless shelters, are not the answer. (My LO serves meals at the homeless shelter many times a week.) He is God’s child first and mine second. We hear our region referred to as the Bible Belt, how can we accept that our government has decided that this portion of God’s children are less worthy of care than others. I realize these are hard times for us all. There are great minds in this state. I challenge them
to find a way to fund, research cures and care for our mentally ill. Many of our mentally ill have very high IQ’s, with proper care who knows what they can accomplish but without care there relapses will continue to degrade there ability to function.
apologies if I am taking too much space…. more info: circa 1974, Boston, MA. I was working at the Shriner’s Hospital for [severely burned] Children, next to Massachusetts General Hosp. My soon-to-be-husband was employed by the State as an outreach worker for adult men with severe chronic mental illnesses. This was the beginning of a poorly thought out and essentially cruel decision to empty out the State hospitals because “community living” would be kinder/gentler. These men were placed in homes where the landlord agreed to provide certain services and receive money from the State. The men were in no shape to handle this transition and, of course, there was nowhere near enough supervision. We spent quite a few nights searching the emergency rooms of all the Boston acute care hospitals trying to find these haunted men. The pay for this outreach work was minimum wage. Even still, the outreach program was cut. I continued on at the Shriner’s Hospital, my S.O. got another outreach job, this time with at-risk children in the ghetto neighborhoods/communities surrounding Boston. Again, minimum wage. This was actually a very good and effective program ~~ and, of course, it too was cut. The children, abandoned to their fates. There were a few State institutions left open back then. One of them was euphemistically called the “Fernald School.” I know this place well. More than I can describe here in this forum. I will refer readers to this link, however:
http://books.simonandschuster.com/State-Boys-Rebellion/Michael-D'Antonio/9780743245135
Few of the children at Fernald had parents who cared. The few (very very few) parents who visited had no idea of the daily conditions their children were actually enduring.
Laws and budgets are one dimension of the problem we face. My neighbors who vote, however, are voting for these legislators who cut our mental health, and medicaid budgets. I cannot get through to them. They fully believe the propaganda that those who seek aid are thieves and liars “ripping taxpayers off.” I cannot get through….and in some ways I sort of expect this level of ignorance from “civilians,” but I hear more vitriol from those involved in health care and I don’t know where to go now.
A very valuable and brave post. Although I have had regular psych care for depression and narcolepsy for over 20 years, I had no idea about the poor and limited psychiatric hospitalization options in Alabama, esp. for adolescents.
When I took my LO to Huntsville Hospital’s Women’s and Children’s after she had a breakdown following a vicious beating by her boyfriend, I assumed that there was a wing on one of its floors for psych care of adolescents and children. There isn’t. When she was encouraged to sign herself into Decatur General West, I assumed she would be going to a safe, supportive, gentle hospital. It is far more like a d-home. When we got there and heard we’d have no contact with her til after the family meeting, and then one call a day from the nurse’s station if she had earned enough stars, I should have taken her home, When she finally could call, and I learned that there was only a male tech on a mixed-sex ward that night who threatened kids with solitary confinement if they cried, I was determined she would be out the next day. She was. Her first psych follow-up was scheduled for 25 days later, but I did find her a therapist immediately.
A few months later she attempted suicide, and HH would not release her to us even if we could have found a bed at a real hospital in Birmingham or Vanderbilt. She wouldn’t sign herself back in, the social workers said they’d get DHR, that she was going there, the hard way or the easy way. So she signed. This was a Friday, We couldn’t see or talk to her til Tuesday. Then she lost her phone privilege, such as it was, by demanding to see an administrator: she had signed herself in, why could she not now sign herself out (good question). The only shrink was at a conference, so a sub drove up weeknights and spent about 5 min with each kid.
Being beaten about the head by the first boy she had ever cared for after an 11-month relationship was bad enough. She continues to suffer from post-concussive syndrome and severe post traumatic stress disorder.
I can’t help but wonder if the PTSD is solely related to the attack, or if these 2 hospitalizations — being cut off from family and friends when she needed them most — are a big part of it.
Oh, and since Alabama doesn’t recognize severe PTSD or post-concussive syndrome as serious physical injury, the boy was charged with a misdemeanor and is about to finish up 6 months of probation. Then his record will be sealed, and he will go on his merry way, just as he has been ever since he did his best to destroy a brilliant and beautiful girl.
Comment: This essay is excellent and I believe you have deciphered Rand’s delusions. Although, to a large extent, I believe “we” have created a closed system in many parts of the US and the world. It has not gone so far as “man-as-island,” but it has gone so far as “Islands” [plural]. Perhaps I have read too much of Kozol’s works…yet he does lay bare our abilities to wall ourselves off from groups in society who we fear. And these walls – for those on the “other” side of them – are impenetrable.
Comment: I fully agree that we are all connected for many of the same reasons you have cited. What worries me is that we ARE experiencing a “die-off,” and it hasn’t caused even a ripple in the moats surrounding the “castles.” There are many many people who believe we that we must be doing well if GDP goes up, not to mention the Dow Jones. The US has more people behind bars than any other nation in the world. To me, this is tantamount to a “die-off.” And the Dow goes up. “Jobs are created,” and “we are coming out of the recession.” Our gaze is once again averted.
What we have allowed (both sides of the aisle) is further silencing of the vulnerable. Or “forced conformity” of the youth of this world as they now carry such a great burden and they are afraid. The most thoughtful young people I speak with quite frequently, are deciding not to have children, out of fear. This is another form of die-off.
Comment: Bankers learned from 2008. What they learned is that they can steal us blind and not pay. They learned they can commit heinous crimes and not be prosecuted. Mostly, they learned that when the next “crash” looms before them, they will much more quickly and quietly get out their parachutes—with the full support of our government, the World Bank, and the IMF. At taxpayer expense.
Eventually, as in Greece, and soon Spain, there will be few taxpayers left. But tax revenues, per se, have never had to match expenditures and money can always be printed. On the political side, the end-game results in a Failed State. Like Haiti. Haiti is an example of what happens with corrupt governance, investment fraud in the form of stealing natural resources, poverty, disease, and total environmental destruction. Haiti is like looking into the future. Yet the wealthy who have benefitted from the rapacious treatment of the people and resources of Haiti, are our neighbors. They are mere holders of 401k’s who don’t have a clue about where their funds are invested. If not Haiti, then Sierra Leone, the DRC, or Bolivia. Same.
Comment: “if we hurt ourselves to help others we are still poisoning the water.”
True statement. Just as voicing anger or outrage only increases the “net level” of suffering in this world. Or, if we raise our voices in angry protest against those in power, we are only adding to the distress of all.
I have to admit to not being evolved enough to buy into these ideas. Perhaps it comes from being marginalized. Or from reading Vaclev Havel in my youth. I have to say that at some level, especially in comparison to my peers, I “hurt myself” everyday to help others. It’s my decision. It’s simply a preference, a freedom I suppose, to choose to fight. I have taken a stand on certain issues which has meant alienation from those who want to appease and accept the status quo. So my list of close friends has grown shorter; there are connections I do not bother to make anymore. My choice. My poison. Stepping out of line, in essence, hurting oneself, invites destruction (MLK, RFK, Ghandi, Bhutto, the Campesinos in Columbia). It’s hard to know what is right.
It is especially difficult to know whether a new philosophical stance will help those in need, eloquent though it is.
Hmmm… I don’t think I explained what I meant about hurting oneself well then. I need to think about it some more. I was thinking that it isn’t possible to help someone else without also in some way helping ourselves– at least we would have some feeling of meaningfulness to know that we had done something useful. If we don’t experience anything positive, we are either not actually helping but just playing martyr (and thus poisoning the water) or we are empathy-impaired. I’m not saying that the internal reward is our primary motive, just that we can’t help having it, because we are connected. I don’t think pure altruism is possible in the real world.
Many of us sacrifice something every day to help other people and definitely experience some negatives, at least being tired– but the satisfaction of knowing it was good makes the net effect beneficial even to one’s self, at least to me. I wouldn’t call that poisoning the water at all. I would say even if I had to give my life to help someone but I believed it was a meaningful choice, it would not be an overall harm.
As far as whether philosophy will help anyone, I don’t know. Maybe you are right. Might be a waste of time. It sure seems to be hurting people right now, and in other places the underlying philosophy of society is saner. It is just hard for me to believe the wrong attitudes are genetic or irreversible. The way Weiss described it, the people who follow Rand describe what sounds similar to a cult conversion– they read the books usually as youths or young adults and her ideas sort of crystallized their thinking. That’s what made me wonder if they could be deprogrammed.
If our social philosophy can’t be changed, then eventually there will be terrible violence. I hope there is another way to fix this.
Here’s an example of poisoning the water, modified from a real life example in my practice. A well-meaning mom worked hard all day and then ran herself ragged driving her only child all over creation every evening to various extracurriculars. She felt unappreciated because the child didn’t want to do all of these things every day and so didn’t thank her. She was hurting herself trying to do something good, and I think the reason she didn’t get a sense of satisfaction was not just that the kid was being snotty– it was that at some level she knew the kid didn’t NEED quite so many activities planned and that she was really doing it to prove to herself that she was helping. I would call that a kind of pseudo-altruism.
Once I got the kid to admit she really wanted some down time during the week and the mom backed down, both of them were happier.
It’s lovely to be thanked by one’s offspring– it means a lot. I got one of those thank-you phone calls from one of mine the other day, for a “no” answer I gave awhile back. This was a decision that actually caused me to need to do more work and make some sacrifices I wouldn’t have needed to make if I had said yes. But at the time, I didn’t need to be thanked for my effort at sticking to the “no” or the inconvenience it caused me — I knew it was right and would help this child, so I felt good about it. The later thank you was icing on the cake!
Yes and I agree with the counterpoint. At a personal level, especially when considering the balancing act between parents and their children, the basics are very clear … over doing it, in a belief that one is “helping,” does poison the water.
Regarding Rand: I have not read Weiss’ book but have always believed Rand’s philosophy to point directly toward the evil end of the spectrum. I found this to be true 30 years ago, and the notion of evil associated with Rand was bolstered when I forced myself to read Alan Greenspan’s bio – he was an ardent devotee of Rand. And Greenspan, even in his own bio, comes across as a sort of twisted human.
Alternatives to Rand and selfishness are desperately needed — in the US and around the world. Rational Connectivism may be the best place to start (or build upon similar concepts), it feels perfect to me. Yet I have a feeling that those who agree with this are already “there.” Or, if they were in positions of real influence, they have been assassinated.
I know “we” have to start somewhere …. and Rational Connectivism is the best way to capture a new direction for humans. New conceptual frameworks can take generations to penetrate the consciousness of individuals.
We ARE, all of us, connected. So my angst comes from knowing that high level goals, ideals, or concepts, cannot immediately help those in need: whether their need is clean water, food, medical care now, a home, or a conflict free environment.
How to implement? How to change minds? How to get people to listen? How many books, scrolls, White Papers, theses, agencies, web pages, blogs, or religions do we need … to promote ideals that are for the collective good?
Perspective Example #1. One of my sons, who has a life-threatening illness-for-life, visited his usual pediatric specialist in Boston. In a misquided effort to be empathetic, the pedi-doc told my son that his illness was worse than Cancer. Now, there are few words which terrorize people more than that one. And since my son’s problem was “worse than Cancer,” he was more than terrified. Later (of course) his anxiety level grew exponentially. The pedi-doc, again trying to help, told my son he now needed psych therapy….My son’s reply was this: “if you can sit me down if front of someone who can tell me there is a cure RIGHT NOW for this disease, I’ll consider talking to that person. Otherwise it’s a waste of my time.” As Paul Farmer puts it: “the cure for thirst is Water, and the cure for hunger is Food.” It’s not going to help to TALK about food while not supplying it….
I use this example as a way to describe the near state of emergency I believe we are in — today — all over the world.
Perspective Example #2 My other son and I were having a conversation last summer when he had a break from college. It was a very broad sweeping discussion about the state of the world, politics, health, environment, Afghanistan, all of it. After a while, he said: ” I know, I know. When you trace it all back to its origins, follow the money, and look at the interlocking Boards of Directors, you find the strings are being pulled by the same 25 White Guys.”
The “White Guy” mix may be slightly different in 2012, and maybe now it’s 30 “guys,” and it’s international — but I think my son was quite right. And whether this small group knows it or not, they are following Rand’s tenets.
So, can this small group start to change — and consider Rational Collectivism as a better alternative? I don’t know. Their castles are high, and their moats are deep.
I’m there…and will continue to promote this Ideal in every venue where my voice can be heard.
errata: should be Rational Connectionism
apologies
Thank you very much for this post. This is a subject very dear to me, since the LO, in my case, is me. In many ways I have been very lucky; for one, ever since I was diagnosed, I’ve always wanted treatment. But I have primarily been lucky because my parents could afford to pay for my care when I was at my sickest and needed thousands of dollars in therapy and medication every month, which insurance would not cover. I am convinced that without that intensive treatment (which was a follow-up to a series of hospitalizations), I would be dead by now. I’m also lucky because, after considerable trial and error, I found a mix of medications that works for me. It distresses me whenever I see benefits for the mentally ill–from hospital beds to outpatient resources–slashed because I know firsthand how hard it is to function and cope when unwell. You need SO much help to get the simplest things done. I’ve been very open about my struggles and have found that in being open, people are open to me in return. It turns out everyone has an aunt/brother/child/friend with a mental illness and I hope to do what I can to make it easier for people to talk about these things. Currently, treatments don’t exist to help everyone with a mental illness, but I do believe that as our understanding of the brain improves, so will treatments, and I firmly believe that a lot more people could be doing better than they are if they had access to good care. The better the care, the greater the chance that someone will be able to work or even just participate in society, contributing to their own happiness and the happiness of their loved ones. As a “high functioning” individual with a mental illness, I believe it is my responsibility to share my story and perspective so others can better understand what it means to have a mental illness–and what it means to have access to treatment. I write about this in my blog from time to time and hope very much that you will read this post and share it with those who might also find it meaningful. http://c-creativity.blogspot.com/2012/02/more-than-just-my-diagnoses.html
Dr. Abston is a wonderful person who works tirelessly for the less fortunate.I was at the Republicans againt Womens Rights protest rally today at Big Spring Park. It was a beautiful day with lots of angry Democrats voicing their opinions about the Legislature passing this awful, insulting bill against women’s health – and how dumb it makes women appear. The real dumb one though is Senator Clay Scofield who wrote the bill. Guess what? He’s 39- year- old farmer who has never been married. I can’t find out for sure if he graduated from college. And he’s telling Pippa Abston, M.D. , PhD, and all women what’s good for us and our bodies. It makes my blood boil.
Dr. Abston was one of the speakers at today’s rally. Unfortunately, I had to leave for another commitment and did not get to hear her speak.
Thank you Pippa for all you do for the poor and for all of us.
Esther Davis
Huntsville